20例腹膜后原发肿瘤及肿瘤样病变的影像学诊断分析

目的 探讨腹膜后原发肿瘤及肿瘤样病变的影像学诊断价值.方法 对20例经术后病理证实的腹膜后肿瘤的X线、CT、MRI表现特点进行分析.结果 CT及MRI的定位诊断准确率较高,为85%和100%.良恶性肿瘤的大小无明显差异.CT与MRI可显示肿瘤的大小形态与周围组织的关联.结论 CT、MRI定位价值较高,对明确肿瘤的境界...     

腹膜后肿瘤和肿瘤样病变CT诊断价值

目的 分析腹膜后肿瘤和肿瘤样病变CT表现,探讨CT对其定位、定性诊断的价值和限度.方法 回顾性分析45例经手术病理证实的腹膜后肿瘤患者的CT资料,并与病理结果对照.结果 良性25例、恶性20例.良性病变CT显示密度均匀,轮廓光滑,边界清晰;恶性病变CT显示混杂密度,瘤体大而不规则.CT定位诊断正确率87%,良、恶性诊断准确率78%,组织类型诊断率49%.结论 CT对腹膜后肿瘤诊断有重要价值,对肿瘤定位诊断准确,对良恶性鉴别有帮助,但对病理组织类型诊断有限度.     

鞍上区常见肿瘤及肿瘤样病变的CT表现

目的：探讨鞍上区常见肿瘤和肿瘤样病变的CT表现。方法：对13例经病理证实的鞍上区肿瘤和肿瘤样病变的CT表现作回顾性分析。结果：CT检查是观察鞍上区肿瘤及肿瘤样病变较可靠的方法，并对鞍上区肿瘤及肿瘤样病变的鉴别诊断有较高的价值。结论：CT检查可以准确地显示鞍上区肿瘤及肿瘤样病变的部位、大小形态强化特点及其与周围组织结构的关系，对诊断有重要的价值。     

腮腺区肿瘤的CT和MRI诊断及病理联系

目的：探讨CT和MRI对腮腺区肿瘤的诊断价值，方法：对72例腮腺区肿瘤（良性36例，恶性36例）进行CT和MRI检查，检查结果与术后病理进行对照，结果：腮腺肿瘤大多位于腮腺浅叶（44／72），良性肿瘤以混合瘤居多（26／36），CT和MRI表现为境界清楚，密度均匀的肿块，CT和MRI测量结果与术后病理大小一致，恶性肿瘤以粘液表皮样癌较多（14／28），CT和MRI多显示为境界不清，密度不均的肿块，术前测量大小常小于术后病理结果；转移癌以鼻咽部来源多见（6／8），72例腮腺肿瘤中，术前定位准确率为100％，良恶性性质判断准确率为95．8％，结论：CT和MRI对腮腺区肿瘤的定位，定量及定性较为准确，具有较大的价值，对面神经的显示MRI优于CT。     

超声与CT/MRI对软组织肿瘤的诊断价值

目的：：探讨超声( US)与CT/MRI对软组织肿瘤的诊断价值。方法：回顾性分析120例软组织肿瘤的术前超声与CT及MRI结果,分析超声与CT/MRI对软组织肿瘤诊断灵敏度及特异度。结果：超声、CT及MRI对软组织良性肿瘤诊断灵敏度分别为63.6％、76.5％、80％,特异度分别为50％、51.5％、71.1％,超声与CT之间差异无统计学意义,超声与MRI之间差异有统计学意义;超声、CT及MRI对软组织恶性肿瘤诊断灵敏度不高,超声与CT/MRI之间差异无统计学意义。超声、CT及MRI对软组织恶性肿瘤诊断特异度较高,超声与CT/MRI之间差异有统计学意义。结论：超声具有方便快捷、实时廉价、可重复性强等优点,可对大部分良性肿瘤做出定性诊断,应该为软组织肿瘤首选的检查方法。 CT/MRI检查除了对脂肪瘤的灵敏度及特异度均比较高以外,对绝大部分软组织肿瘤诊断能力不高于超声。对于少部分复杂肿瘤,可以多种影像学检查相互结合补充。     

腹膜后肿瘤的CT/MRI影像学诊断

目的:探讨腹膜后肿瘤的CT/MRI影像学特点与病理表现的关系,提高腹膜后肿瘤诊断及鉴别诊断水平。方法:回顾分析我院2006年3月～2011年10月经手术病理确诊的31例腹膜后肿瘤的CT/MRI表现,并与临床资料及病理检查结果进行对比分析。结果:31例术前CT/MRI检查均显示腹膜后占位性病变,病理示良性13例,恶性18例。按组织起源分类,其中间叶组织肿瘤13例(脂肪肉瘤6例、脂肪瘤3例、平滑肌肉瘤1例、平滑肌瘤2例、恶性纤维组织细胞瘤1例);神经源性肿瘤9例(神经鞘瘤5例、恶性神经鞘瘤1例、副神经节瘤3例);胚胎残余组织肿瘤(精原细胞瘤)1例;淋巴瘤8例。CT/MRI定位诊断正确率93.5%(29/31),组织学类型诊断正确率58.1%(18/31)。CT/MRI可比较直观地显示肿瘤的大小、形态及周围组织情况,并可进行肿瘤部分成分的分析。结论:CT/MRI影像学表现及部分成分分析,对腹膜后肿瘤的诊断有重要价值。     

螺旋CT对原发性腹膜后肿瘤的诊断价值(附36例报告)

目的探讨CT诊断及三维重建对原发性腹膜后肿瘤的诊断价值。方法分析36例经手术病理证实的原发性腹膜后肿瘤的CT表现。结果CT及三维重建可获得肿瘤部位优质的冠状、矢状位图像,能清晰地显示病灶的部位、大小、内部结构及邻近组织的关系。结论CT及三维重建能对原发性腹膜后肿瘤的定位、定性诊断提供可靠的影像学依据。     

腮腺区肿瘤的CT和MRI诊断及病理联系

目的探讨CT和MRI对腮腺区肿瘤的诊断价值.方法对72例腮腺区肿瘤(良性36例,恶性36例)进行CT和MRI检查,检查结果与术后病理进行对照.结果腮腺肿瘤大多位于腮腺浅叶(44/72),良性肿瘤以混合瘤居多(26/36),CT和MRI表现为境界清楚、密度均匀的肿块,CT和MRI测量结果与术后病理大小一致;恶性肿瘤以粘液表皮样癌较多(14/28),CT和MRI多显示为境界不清、密度不均的肿块,术前测量大小常小于术后病理结果;转移癌以鼻咽部来源多见(6/8).72例腮腺肿瘤中,术前定位准确率为100%,良恶性性质判断准确率为95.8%.结论CT和MRI对腮腺区肿瘤的定位、定最及定性较为准确,具有较大的价值,对面神经的显示MRI优于CT.     

原发性腹膜后肿瘤的CT诊断分析

目的探讨CT在腹膜后肿瘤中的诊断价值。方法回顾性分析32例经病理证实的原发性腹膜后肿瘤的CT影像学表现。结果CT定位诊断符合率为875％,良恶性诊断符合率为90．63％对部分肿瘤可直接进行病理学诊断。结论CT对原发性腹膜后肿瘤定位诊断及良恶性诊断可靠,对病理学诊断亦能提供一定线索。     

椎体肿瘤及瘤样病变的临床分析和影像学改变

目的探讨椎体肿瘤及肿瘤样病变和影像学诊断价值。方法对椎体肿瘤及肿瘤样病变的患者进行X线摄影、CT、MRI影像学分析。结果椎体肿瘤及肿瘤样病变的患者进行X线摄影、CT、MRI等影像改变各有特异性。结论椎体肿瘤及肿瘤样病变的患者影像学改变要与临床分析相结合,诊断符合率才最准确。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.